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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1570778

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1. Jazz Pharmaceuticals, Inc. Political Action Committee

    NOTE:Commmittee Name is different than previously reported

    28 Liberty Ship Way, Suite 2815
    Sausalito, CA 94965
    Email: reporting@politicomlaw.com

2. Date: 02/18/2022

3. FEC Committee ID #: C00721811 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Greenwich Biosciences, Inc.
5750 Fleet Street, Suite 200
Carlsbad, California 92008
Affiliated Relationship Code: Connected Organization

Jazz Pharmaceuticals, Inc.
3170 Porter Drive
Palo Alto, California 94304
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jennie Unger Skelton
28 Liberty Ship Way, Suite 2815
Sausalito, CA 94965
Title: Custodian of Records
Phone # (415) 903-2800

Treasurer:

Jennie Unger Skelton
28 Liberty Ship Way, Suite 2815
Sausalito, California 94965
Title: Treasurer
Phone # (415) 903-2800

Designated Agent(s):

Erin Christine Lama
28 Liberty Ship Way, Suite 2815
Sausalito, California 94965
Title: Assistant Treasurer
Phone # (415) 903-2800

Banks or Depositories

Bank of Marin
2656 Bridgeway, Suite D
Sausalito, California 94965

Signed: Jennie Skelton
Date Signed: 02/18/2022

(End FEC FORM 1)

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